– I’m really scared now. It’s just the court case on his mind all the time. Silje sits on the sofa with her legs in a tailored position to relax her stomach as much as possible. In her hand she holds a pain device which is connected to several electrodes on the body. At regular intervals she presses the button and gives herself little noises to relieve the pain. – For seven years I have heard that the pain does not make sense, that it is not possible to have such pain after an appendectomy. It is tiring to fight all the time to be believed, she says. Photo: Patrick da Silva Sæther / news Silje walks slowly across the floor to fetch a glass of water. There is not much more she can say. – One kilo is far too heavy, because I use the abdominal muscles around the injury in such a way that it creates extreme pain, she explains. Some days she manages to make herself breakfast and carry the plate over to the sofa. On good days, she can meet friends. On bad days she has to stay in bed. Now she is fighting a battle she doesn’t know if she can endure or win. Photo: Patrick da Silva Sæther / news She has sued the state for compensation after the appendectomy which left her 100 per cent disabled. If she wins, she could be awarded millions. If she loses, she could be left with a huge bill. – It is very scary. I would never have been able to do it without my mother and my lawyer, she says. A completely routine operation For Silje, this story started just before the Russian era. She was 18 and juggling school, training and a part-time job. Silje had plans and dreams about the future, like all other teenagers. – I hadn’t quite decided what I wanted to be, but I wanted to study. Maybe photojournalism in Denmark. In any case, I wanted to go out and travel, says Silje. It didn’t turn out that way. Photo: Patrick da Silva Sæther / news One evening she was studying for an exam, she had acute stomach pains. The doctors suspected appendicitis and the same night she was wheeled onto the operating table. With three small incisions in the abdomen, the appendix was removed using cecal surgery. It is a routine operation that is carried out thousands of times a year in Norwegian hospitals, but for Silje the operation was the start of a nightmare. – The doctors said the pain would go away, but they didn’t. It was seven years ago and it’s still exactly the same, she says. Today, Silje still lives at home and is completely dependent on help to cope with everyday life. Photo: Patrick da Silva Sæther / news The dream of studying abroad has been put aside for good. – It was hard to see that everyone else moved on, while my life stopped, she says. After the appendectomy, Silje was sent for countless examinations and treatments, in various attempts to remove the pain. Nothing helped. Gradually, the healthcare system could only offer pain relief and pain management. Photo: Patrick da Silva Sæther / news She has never received a clear explanation of what happened the night the appendix was removed. – No one admits that a mistake has occurred, or says that the pain comes from the operation. It is very frustrating, she says. In the years after the operation, she has been to various doctors, physiotherapists and therapists, at her own expense. She spends over eight thousand kroner a month on treatments that make it a little easier to live with the pain. The fight for compensation Silje has spent a lot of time deciding whether she should go to trial or not. If she could. If she could afford it. In the podcast “On the inside of the court”, news follows Silje’s fight for compensation. For three days, Silje’s medical history is unfolded and analyzed in courtroom 257. We hear the step of the judge long before the door opens. Everyone gets up. Silje grabs the edge of the table and puts her weight on one leg. Then she stands before the judge who has the power to change her life. – Just before the trial, I was terrified. Mum had to hold me in her hands because I was shaking so much, says Silje. Silje takes a seat in the witness box and tells how life changed overnight. – I worked and had a great leisure life. Now I needed help with everything. Carry things, cook and wash your hair, Silje tells. Then it’s mom’s turn to testify. She has recorded a video of Silje which the court will be allowed to see. On a big screen, we see Silje howling in pain as she stabs herself against the sofa in her own living room. Why are you filming? asks Silje’s lawyer Janne Larsen. – I film her because I feel that Silje is not taken seriously, explains her mother. On the opposite side of Silje sits the lawyer for the state with his experts. Later, they will testify about why they do not think the severe pain comes from the appendectomy. Then everything is up to the district court judge. Is Silje entitled to compensation? Illustration: Kjersti Lofthaug / news The crowded needle guild In recent years, more and more people have applied for compensation for patient injuries. Around 70 per cent of all applicants are rejected, according to figures from Norwegian Patient Injury Compensation. Silje also got that. First she had the application rejected and then the complaint. Then the last possibility is to go to court. The lawyer for the state, Bianca Reichelt, explains why the state believes that Silje is not entitled to compensation. – In order to have a claim for compensation, as a general rule, an error must have occurred during the processing. That didn’t happen to Silje. She came in with a serious illness and has received good health care in line with current guidelines, she says. Bianca Reichelt believes Silje has been unlucky and suffered a rare but well-known complication. She clarifies that it is not risk-free to be treated. But should one accept being so injured by a routine appendectomy? No, says lawyer Janne Larsen. She has been Silje’s lawyer since the first application for compensation was sent over five years ago. – I think most people see an appendectomy as a trivially small operation, with little risk. Should one really tolerate being disabled and not receiving compensation? I think it’s unreasonable, she says. Illustration: Kjersti Lofthaug / news The exception, Janne Larsen, specializes in patient injury cases, and thinks the state interprets the law far too strictly. She refers to an exception rule which she believes entitles Silje to compensation. The Patient Injury Act states that one can be entitled to compensation if the damage is particularly large and unexpected. – Silje was healthy and fast, and had a very low risk of complications. Now she is, so to speak, the link to home after a completely routine operation. In my opinion, there is no doubt that this is a particularly large and unexpected injury, she says. But there are very few who receive compensation under this provision. In the last ten years, only 28 people have received compensation under the exception rule after complaining about the decision from Norwegian Patient Injury Compensation. The legal system has maintained the strict interpretation of the law. Since 2006, the Supreme Court has dealt with eight court cases concerning the exception rule. None of the patients have won. – It will take an extremely long time to get compensation according to this pre-sign, says Bianca Reichelt. She adds that it would be very expensive if the state were to be objectively responsible for all complications that arise without there having been an error or failure in the treatment. The winner in the district court A few weeks after the trial, the verdict is clear. Silje smiles when she thinks back to the blink of an eye that she will remember forever. – I completely broke down when my lawyer said that we won. I had no reason to believe that we could win over the state. But we did, she laughs. The judgment states that Silje was operated on in line with good medical practice. There was no failure in the treatment, but the exception rule still entitles her to compensation. “It cannot be the legislator’s opinion that since a person really needs health care, then in practice one has accepted all possible risks that things could go wrong, and that it should only be relevant to provide compensation for treatment of more minor health problems. It is unlikely to be in line with the general sense of justice, which is the reason why the exception rule exists,” the judgment states. For Silje, the sentence was an extremely light one. – I was heard and believed, she smiles. But the joy was short-lived. A few weeks later, word came that the state would appeal. The case goes on to the Court of Appeal. Illustration: Kjersti Lofthaug / news – The state is a powerful counterparty – It is the legislators who have decided that we shall have a strict practice, says the lawyer for the state, Bianca Reichelt. She clarifies that this is not about believing in Silje or not. It is about how the law is to be put into practice. – The state believes the judgment is wrong and contrary to the practice of the Supreme Court. That is why the state is appealing, says Bianca Reichelt. Silje’s lawyer does not agree. – In my view, this type of damage is in the core area of this prediction and I cannot understand that the state appealed this case, says Janne Larsen. The parties will soon meet for a new round in court. The Court of Appeal will then decide whether Silje fell within or outside the exception rule. Silje’s mother poked her head in through the door to check that she is okay. – Do you need anything Silje? Shall I get you something? After seven years in combat mode, it takes its toll. – The state is a powerful counterparty. It’s David against Goliath, sighs the mother. Silje is completely clear that she would never have managed this match without her mother. – I am very lucky to have a mother who helps me. Both practical and economical, says ho. Photo: Patrick da Silva Sæther / news A vital battle They have already spent many hundreds of thousands of kroner on legal fees and expert assessments. What the bill will be in the end, no one knows yet. If Silje loses in the Court of Appeal, she will have to pay the entire bill. Are you sure it’s worth it? – If I win, it will change my life. Today, for example, I cannot get a home loan as a disabled person. A win in court will provide financial security for the future, which I do not have today. But for me this is primarily about being heard and believed, she says. Soon she will be in court for the second time in her life. She hopes it will be the last. – This fight has made me sicker and put my life on hold. Right now I think that the state will never give up. But I can’t bear to think about that now, she says. Now she has more than enough to gather her strength for four new days in court. – Last time I was so nervous and felt so small and stupid. Now I am more mentally prepared. I know it will be tiring, but I also know I can handle it. She has already won one in court, which gives her strength to fight for one more. – The judge believed in me. That feeling is so fundamental that in any case I have received the confirmation I need. My life is true.
ttn-69
Young disabled person after appendectomy – Documentary
